Coping With Loss And Bereavement

Introduction
I have written this article in response to requests to offer some support and advice in this difficult area. I am primarily talking about loss associated with bereavement but any deep and significant loss in life can produce a similar response in us - the intensity and duration may differ.
If you are reading this having suffered a loss please accept my sympathies. Once we get to a certain stage in life it is inevitable that we will experience the death of loved ones and have to endure the associated pain involved. It is an immutable part of the human condition, but knowing it does not make it any easier to endure, and generally we prefer not to think about it, pushing the thoughts to the recesses of our minds.
However, I have found in my experiences of working professionally with the bereaved, and in my own personal experiences of the deaths of loved ones, that understanding some of the processes of grieving and mourning can actually help, just a little. Knowing that our responses are ‘normal’ can be a comfort. And also understanding more can help us offer comfort to others. Throughout this article there are also useful tips for offering support to the bereaved.

That said, everyone experiences grief in their own way and what follows is not a recipe or short cut. I can’t describe a typical response because there isn’t one as such. And how you experience it on one occasion is not necessarily how you will experience it again. But by and large we all follow a similar psychological processes, expressed in different ways according to our uniqueness as individuals, and it is those common elements I am exploring in this article. If your particular expression of grief does not follow this pattern then that is perfectly OK, you must do what is right for you.

Shock
Our first response to news of a death is usually shock. We’re likely to experience this even if we have been expecting it, for example, when someone has been ill for a long time and we may have already begun our grieving (anticipatory grieving). Intellectually we know the end is inevitable but it’s as if our hearts are hearing it for the first time. Others less close to events may find this hard to understand and may assume that our prior knowledge has readied us for the loss. To a degree that can be true, but you are still likely to experience shock as your first emotion.
If the loss is totally unexpected then the shock can be tremendous, and the circumstances of the death can have a huge impact on how we experience our grief . There is little anyone offering support can do at this stage except just ‘be there’ for anyone going through it. When the shock is immense then sometimes the bereaved may actually experience physical symptoms or trauma requiring medical intervention .

Listening to the bereaved can be of help as their talk allows the awful fact to become reality. Also pay attention to their other needs such as having food in the house, letting relevant people know, and so on.

DenialA second common response, once the first shock waves have abated, is a refusal to believe the news. Our brains (or maybe that’s our hearts again) seem somehow to want to try and protect us for a little longer by refusing to process the news. We may need evidence; we may need to be told several times; we may be compelled to visit the scene; we may need to see the person themselves if possible.

This is where someone less involved can offer help, by hearing the facts and gently repeating them when appropriate. Some enlightened doctors know, when they are breaking bad news to patients, that they rarely hear past the initial few sentences, and so have begun recording the consultation so that they may listen to it later when they are ready to absorb the information. In extreme cases this phase of denial can last a while and need specialist help.

BargainingA bargaining phase was described by Dr Elizabeth Kubler-Ross in her work with terminally ill patients. She noted that part of the process of grieving sometimes involved a sort of plea bargaining on the part of the person experiencing the loss. For example, “If I do this, it will make this news/event/horror go away” even if it is obvious that it cannot happen. It is unrealistic but again, a normal response.

Anger & Guilt
In my experience this is often the least known fact of the grieving process and the manifestation or appearance of which causes the most anguish. It is very normal and common to feel anger after loss and, disconcertingly, this anger can sometimes be directed at the person who has died. The more we try to suppress this feeling the more distress it can cause us as we feel it to be unreasonable, uncaring, and just plain wrong.

We probably feel unable to share this emotion, if indeed we recognise it for what it is. It may be that the anger then gets misdirected towards those who are offering us comfort, or those suffering alongside us.We may direct the anger inwards towards ourselves in the form of guilt, punishing ourselves for what we did or did not do, or for feeling angry. These feelings may be entirely irrational but they are normal. Guilt is a common reaction to loss. It is helpful if you can share this feeling with someone. Often that is enough, recognising it and naming it. It may last a very short space of time (minutes) or much longer.

If you are offering comfort to someone try not to be dismissive of their feelings of guilt. Help them tell you their feelings, encourage them to try and put it into words and then gently you can help them explore it further. You may feel shocked by what they say in the depths of their grief but try not to show it. Reassure them that this is a normal reaction and that they are not monsters for feeling it. If the feeling is persisting beyond the funeral it can hinder the healing process of grieving so it may be worth considering some sessions with a bereavement counsellor.

Depression or Intense Sorrow
As the reality of the loss sets in we become very low, even perhaps depressed, although be careful not to confuse being intensely sad with depression . You cannot short circuit this process; it is painful but the raw intensity of it will pass. I sometimes describe it as the bitter sweetness of grief; if we hadn’t had the sweet gift of loving or caring for someone then we wouldn’t have the bitter taste of grief.
In times gone by we had a much more proscribed way of managing the aftermath of a death. For example, in Victorian Britain there was a very formal set period of mourning, when our behaviour, and even our clothing, was decreed. To overstep this was considered an act of disrespect. I am not suggesting a return to this rigidity of approach as we’re all unique and all need to find our own way, but at these difficult times in our lives ritual can be important and help us through. The absence of it can leave us not quite knowing how to behave, how to manage our grief.

When my grandmother died I remember my mother keeping the curtains closed and wearing a black armband for some time afterwards. At the time I didn’t appreciate the significance of this but those two symbols sent a very clear message to others about what had happened. The wearing of an arm band said ‘I am in mourning so don’t expect me to be as I usually am, I have lost someone significant in my life’.

Ideas That May Help
Lack of these formal traditions has led many to create their own which can be just as valid and significant. Humans of all cultures have created ceremonies throughout time to help mark significant events and to recognise that something has changed, (like marriage ceremonies) so creating some of your own can be therapeutic.
If we have a faith the ceremonies associated with this can bring us great comfort as can our beliefs in what happens beyond death. At times of great stress we sometimes turn back to a faith we have grown up with but perhaps abandoned, for the familiar feelings of security and comfort it brings us.

There are other nonreligious things we can do during this intense period of loss that can bring comfort and help us through the grieving processes. You may choose to write about your loved one in a journal. If there is some unfinished business you can write a letter to the person saying the things you never got to say. This may feel a bit daft at first but it is your personal ritual so do what feels right for you. Once it is written you may decide just to burn it, or take it to a favourite spot and both literally and metaphorically, just let it go.

Or perhaps you could create a scrapbook or photographic collage about the person; create an appropriate memorial in his or her honour, or have a simple vase engraved with their name which you keep full of fresh flowers as your own private tribute.

There can be comfort too in channelling some of your feelings into a cause that was close to their heart, like fundraising for a particular charity . If you are trying to help a friend or relative through the grieving process maybe this is something you could offer to do with them.

Experiment
At some point, and this will of course vary from person to person, we begin to move on. You may find, perhaps with a guilty stab of surprise, you have managed to go a whole half day without that acute consciousness of loss or even thinking about the person. This is normal and healthy and does not mean you have become hardened to the loss or are showing disrespect.An important part of the process of mourning is learning to live with the altered circumstances that you find yourself in.

Mourning is learning to let go of the person you have lost. This does not mean forgetting them, not in any sense. It means learning to live a life without them that is different from what went before. So, in this phase, we experiment with new ways of behaving. Maybe it’s something as simple as driving a new route or cooking in a way you like but they didn’t.

You may belong to a culture which has a set way of behaving during this time, which can be a comfort. During this period of adjustment you will have good days and bad days and days when it feels like you are back to square one. But actually, however it feels, you never go right back to the beginning; you have been making progress through the mourning process and making small adjustments to cope with the loss.

TimingThe length of time we grieve and mourn varies from individual to individual and circumstance to circumstance. You probably won’t be able to look back and say it happened on a particular day. Rather you gradually realize that the intensity has lessened, the burden of grief is lifting slightly and you begin to feel a little like the person you used to be before your loss.

Pay Attention to Your Health
During the period of grief and mourning you are very susceptible to ill health. You are probably not eating properly and you may rely on other less healthy ways of trying to numb the pain, such as excessive use of alcohol. If you are someone who regularly takes vitamins and health supplements you will possibly let this lapse, feeling there is no point. However hard it is, try to pay attention to yourself and look after your physical needs.The power of touch can be very healing so maybe a neck and shoulder massage will be beneficial. Let close friends offer you comfort, be it with a handshake or a hug. People want to help but they often don’t know how. If you need a hug, ask them.

Possibly you may be offered pharmaceutical help by your doctor. If you can, try and avoid this as it will only succeed in numbing you to pain; it doesn’t help you through the process and there are no shortcuts. Of course, take medical advice, but just be aware that there is no magic pill and weigh up your options.

AnniversariesThe year following a death can be full of painful 'firsts'. The first anniversary of the death may be as painful as the event itself was. Knowing this can help you plan for it. You may need to make sure it’s day you are not working, or for you it may need to be a day you are working and busy, surrounded by people. You may decide to spend anniversaries with other people who shared your loss, or you may decide to remind no one and keep your feelings to yourself.

Again, ritual can be helpful at this time, be it lighting candle, taking flowers to an appropriate place, or just sharing your memories with a sympathetic audience.

Helping
In Western culture, as I have said, we have lost many of our traditions around grief and mourning; that can leave us feeling awkward and ill at ease around people who have experienced loss. I will never forget working with a young woman who had lost her child, her distress deepened by neighbours who had taken to crossing the street when they saw her because they didn’t know what to say. Grief can make us feel very alone and avoiding someone who is bereaved only intensifies this.
We all feel awkward when confronted with another’s pain and it sometimes seems better to say nothing rather than risk saying the wrong thing. Take that risk and extend the hand of caring and support. Literally, a hand on someone’s arm can convey your sympathies more than words. Sometimes it’s not appropriate to mention it directly, at work maybe when someone is absorbed in their task, so we need to use our discretion. But don’t let fear hold you back from acts of common humanity, be it taking some homemade food round, a card sincerely written, or an offer of help with the shopping.

Conclusion
There are no shortcuts and your experience of grief will not necessarily follow the patterns described. I hope it has been helpful however, whether for you personally, or in giving you more confidence to offer support to others. Please use the link below to forward it to anyone who might find it helpful.‘ Everything that has a beginning has an ending. Make your peace with that and all will be well’